| Objective To explore the impacts of emergency laparoscopic appendectomy on pancreatic endocrine function and the prognosis in type 2 diabetic patients.Methods Retrospectively analyzed the clinical data of 76 cases of type 2 diabetic patients with acute suppurative appendicitis who were admitted to Yongchuan Hospital Chongqing Medical University from 2012.10to2014.10 Patients were underwent appendectomy,41 cases in laparoscopic surgery group were underwent Laparoscopic appendectomy, 35 cases in laparotomy surgery group were underwent the open appendectomy..The condition of patients during the surgery were observed,Testing the level of patients'serum insuli?C peptide and blood glucose in 15min before the surgery (t1),15 min intraoperative period (t2), 30 min intraoperative period (t3),30 min after surgery (t4) with ELISA technique and analysing the prognostic indicators,patients were followed up by telephone till December 2014.The measurement data of normal distribution were expressed by x±5, comparison between groups were used the unpaired t test and repeated measures analysis of variance, Count data were compared by chi square test or Fisher's 2 Calculation of exact probability, p<0.05 had significant difference.Results:Patients of two groups were completed the operation smoothly.The operation time and the amount of bleeding during the operation of laparoscopic group was(50.12+7.43)min and(8.41+3.39) ml, while the laparotomy group was (52.31+7.31)min and(7.66+2.86), the difference between the two groups was not statistically significant (t=1.291,t= 1.042, p>0.05).There were 8 cases in the laparoscopic group were found of serious adhesions of tissues around the epityphlon,while the laparotomy group were 11 cases, the difference was not statistically significant (p>0.05).The monitoring results of serological marker display:The monitoring results(T1-T4) of serum C peptide in the laparoscopic group were:(62.5+3.3)ng/mL?(70.7+2.9)ng/mL (86.5+3.4)ng/mL?(68.1+2.6)ng/mL,while the open group were:(63.8+2.8)ng/mL?(95.6+5.1)ng/mL?(106.6+2.3)ng/mL? (67.5+4.9)ng/mL;The monitoring results(T1-T4) of serum insulin in the laparoscopic group were:(13.1+1.0)mU/L?(14.0+1.1)mU/L (15.1+1.2)mU/L?(13.5+1.1)mU/L;while the open group were:(13.3+0.4) mU/L?(15.4+0.6) mU/L?(18.2+0.7) mU/L?(13.5+0.4) mU/L;The monitoring results(T1-T4) of blood glucose in the laparoscopic group were: (7.8+1.0)mmol/L. (8.3+1.0)mmol/L?(8.9+1.0)mmol/L? (8.1+1.0)mmol/L;while the open group were:(7.8+0.4)mmol/L? (8.7+0.5)mmol/L?(10.1+0.4)mmol/L?(7.9+0.5)mmol/L.The trend of the 3 kind of serological index were different between the two groups, the difference was statistically significant (F=378.917,286.602,118.199, P<0.05) The recovery of patients after operation:The duration of the postoperative abdominal pain of the patients in the laparoscopic group was (1.46+0.60)d.while the open group was (2.46+0.74) d, the difference between the two groups was statistically significant (t=-6.367,p<0.05).There were 6 cases in the laparoscopic group were found of wound infection and 10 cases were had a fever,while the laparotomy group were 14 cases and 22 cases,the difference was statistically significant (p<0.05).The anal exhaust time of patients in the laparoscopic group was(1.22+0.42) d, laparotomy group was (1.26+0.51)d, the difference between the two groups was no significant difference (p>0.05). Hospitalization time of the laparoscopic group was (5.2+4.2)d, the laparotomy group was (6.3+0.8) d,the difference between the two groups was statistically significant (t=7.796, p<0.05).Conclusion:Comparing with open operation,The emergency laparoscopic appendectomy has little effect on pancreatic endocrine function,may be beneficial for the postoperative rehabilitation of patients type 2 diabetes. |
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